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알레르기 환자에서 면역요법에 따른 면역학적 지표의 변화
최영환,허영구,김항재,김능수 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.2
혼합 항원추출액으로 면역요법시 경과 관찰에 도움이 되는 객관적인 지표를 설정하기 위하여 D. farinae 또는 D. pteronyssinus를 포함한 2내지 6가지 복수의 기인 항원을 갖고 면역요법을 6∼12개월 받은 환자(제Ⅱ군)와 2년 이상 받은 환자(제Ⅲ군)를 대상으로 말초혈액 호산구수, 혈청총IgE치, RAST score, 피부반응도, 말초혈액 IgE수용체보유림프구, 말초혈액 T, B림프구 및 T림프구 아형을 측정하여 면역요법을 받지 않은 알레르기 환자(제Ⅰ군)들에서의 성적과 비교 검토하였다. 혈청총IgE치는 6∼12개월 면역요법군 및 2년이상 면역요법군에서 면역요법을 받지 않은 군보다 유의하게 낮았다. (각각 P<0.05) 면역요법전혈청총IgE치가 400IU/㎖이상인 환자에서는 면역요법후 그 감소가 뚜렷하였으나 300IU/㎖이하인 경우는 유의한 감소를 볼 수 있다. 면역요법을 받지 않았는 군에서의 피부반응도지수의 평균은 1.80±1.79였고 6∼12개월 면역요법을 받은 제Ⅱ군 및 2년이상 면역요법을 받은 제Ⅲ군의 피부반응도지수는 제Ⅰ군보다 각각 유의하게 낮았다. 말초혈액 FcεR(+)림프구는 면역요법을 받지 않았는 Ⅰ군보다 Ⅱ군 및 Ⅲ군에서 유의하게 낮았으나 여전히 정상치 이상이었다. 그러나 혈중 호산구수, RAST score, 말초혈액림프구 및 그 아형은 면역요법 전후 유의한 변화를 나타내지 않았다. 이상의 성적에서 혈청총 IgE치, 피부반응도지수, 말초혈액FcεR(+)림프구는 면역치료의 경과를 대체로 추적할 수 있는 지표가 될 수 있을 것으로 생각된다. To determine the reliable parameters for assessing the efficacy of immunotherapy in multi-allergen sensitive allergy patients, we observed the changes of peripheral blood eosinophil counts, total and specific IgE levels, skin-test reactivity index, Fcε receptor-bearing lymphocytes, T/B lymphocytes and T-subsets in peripheral blood in the three groups of allergic asthma or rhinitis patients, the first group(group Ⅰ) of 102 patients who were not on immunotherapy, the second group(group Ⅱ) of 28 patients who received 6-12 months immunotherapy, and the third one(group Ⅲ) of 24 patients who received 2 years immunotherapy. Those patients were sensitive to 2-6 aeroallergens including D. farinae or D. pteronyssinus and all the patients in group Ⅱ and group Ⅲ had been immunized with the specific desensitization vaccine (SDV, Bencard®), resulting good response on symptoms. Total serum IgE levels were significantly decreased in the groups of Ⅱ and Ⅲ, compared with groupⅠand the decrease in IgE was more prominent in the patients of high IgE level over 400IU/㎖ prior to immunotherapy. The mean of skin-test reactivity index was 1.80±0.79 in group Ⅰ and this index was significantly lowered in group Ⅱ and Ⅲ. Significant decrease in Fcε receptor-bearing lymphocytes in peripheral blood was developed in immunotherapy-received groups(Ⅱ and Ⅲ). However, the patients still had higher levels of Fcε receptor-bearing lymphocytes in peripheral blood than normal controls, even after more than 2 years of immunotherapy. The differences of peripheral blood eosinophil counts, RAST score, T/B lymphocytes and T-subsets were not significant between before and after immunotherapy. These findings suggest that serum IgE, skin-test reactivity index and Fcε receptor-bearing lymphocytes in peripheral blood could be useful parameters in assessing the efficacy of immunotherapy with extracts of multi-allergens.
多發性腎囊腫 가족례 2례 : 蜘蛛膜下出血을 동반한 1례 포함
최연극,김순덕,조동규,김능수,김용주 慶北大學校 醫科大學 1985 慶北醫大誌 Vol.26 No.4
We experienced two families of polycystic kidney disease. Of the two families one case was associated with subarachnoid hemorrhage. We have reviewed the literatures of familial occurrence of polycystic kidney disease, and of the case associated with subarachnoid hemorrhage.
기관지천식환자에서 면역요법 시행중 병발한 크론씨병 1례
강문수,강천일,서영익,황윤근,최영환,이종명,김능수 대한알레르기학회 1993 천식 및 알레르기 Vol.13 No.2
Cronhn's disease is an indolent, chronic inflammatory disorder capable of involving the entire alimentary tract. The exact etiology and pathogenesis remain unknown despite a long and intensive research, but the finding of various abnormalities of the immune response in patients with Cronhs disease has led to the concepts that immune mechanisms are involved in the pathogenesis of this disease. Recently, we have experienced a case of Crohns disease which developed during immunotherapy for 7 years in a 17-year-old asthmatic patient. Since immunotherapy results in the formation of IgG antibodies directed against the immunizing antigens, the production of circulating immune complex(CIC) consisting of IgG antibodies and antigenic components contained in the immunotherapy extracts theoretically could occur. Though the overall risk of CIC-mediated disease in patients undergoing immunotherapy is presumably extremely low, we postulate the immunotherapy could be responsible for the occurrence and/or aggravation of Crohns disease in this patient. A probable causal role of immunotherapy in Crohns disease clearly requires further investigations.
감마인터페론이 말초혈액 단핵구의 IgE 생성능과 FceRII 표현에 미치는 영향
최영환(Young Hwan Choi),강천일(Cheon Il Kang),서영익(Young Ik Seo),황윤근(Youn Keun Hwang),강문수(Moon Soo Kang),이종명(Jong Myung Lee),김능수(Nung Soo Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.1
N/A tendency to decrease after 3days culture of PBMCs with IFN- y in both allergic asthmatics ad healthy individuals. And significant reduction was observed at the concentration of IFN-y 1000 IU/ml in healthy individuals. 3) In case of allergic asmatics, the IgE levels in supernatants of 6days' PBMCs culture with IFN-Υ were significantly lower than those of spontaneous culture. 4) The IgE levels in supernatants of 6 days PBMCs culture with PHA and INF-Υ were significantly higher than those of IFN-Υ only. Conclustion: In asymptomatic patients with allergic asthma, culture of PBMCs with IFN-Υ showed dosedependent reduction. in IgE production and FcεRII expression. These findings may suggest that IFN-Υ is deeply involved in both IgE production and FceRII expression of PBMCs.
단 clone 성 항체를 이용한 정상인의 흉선세포 및 말초혈액 T-림프구의 subsets
이관호,김능수,조동규,최연극 대한내과학회 1986 대한내과학회지 Vol.30 No.4
Human thymocyte and T-cell subsets were quantitated by using OKT4 and OKT8 monoclonal antibodies in thymuses from twelve immunologically healthy children and peripheral blood from twenty healthy adults. And also, a study was done to determine whether the OKT4+T8+ lymphocytes are present in peripheral blood of healthy persons. By the expression of only OKT4 and OKT8, there were four different subsets of thymocytes as OKT4+T8+, OKT4+T8-, OKT4-T8+ and OKT4-T8- with percentages of 63.9, 10.2, 15.6 and 10.2 respectively. The OKT4+ cells and OKT8+ cells in peripheral blood T-cells of healthy persons were present in 57.7% and 31.5%, respectively. The OKT4+T8+ cells were present in 14.5% of healthy human peripheral blood T-cells.
T 및 B cell 測定 : 2·2次 成積 2, Results, Secondary
金在植,崔成萬,金仁子,徐相喆,金重明,朴貞姬,金能守 慶北大學校 醫科大學 1983 慶北醫大誌 Vol.24 No.2
일반적인 疾病狀態에 있어서 末梢血液의 T 및 B cell의 分布를 調査하기 위하여 T 및 B cell 測定을 시행하였던 여러가지 疾患患者중 118명을 대상으로 하여 分析하였다. 年齡別 및 性別에 따른 T 및 B cell에 有意한 差異를 나타내는 경향은 볼 수 없었다. 對照에서 immune deficient state는 正常人에 비하여 T, B cell 및 r-globulin의 有意한 減少를 보였다. 疾病別 T 및 B cell 分布는 惡性腫瘍系統에서 T cell의 減少의 경향이 顯著하나 기타 일반 疾病에서는 甚한 減染症 이외에는 T 및 B cell 모두 정상범위에 分布하는 경향을 보였다. Total T cell과 active T cell의 分布는 서로 相關的으로 같은 경향을 나타내었다. 이상을 종합하면 일반 患者중 末梢血液의 T cell分布의 변화가 그 主 所見이며 惡性腫瘍系統의 疾患에서 主로 T cell계통의 減少를 보이며 일반 炎症性 疾患에서는 T cell은 정상이나 심한 炎症에서 減少의 경향을 보였다. One hundred and eighteen patients of various diseases were examined to explore the distributions of T and B cells in peripheral blood. There were no significant differences among age group and sex in T and B cell percent. In controls of immune defcient state and normal adult, there were remarkable significant decreases of T and B cell series and r-globulin in immune deficient state. T cell series showed a tendency of decreases in malignant conditions like neoplasm and leukemia. No remarkable changes of T cell series were noted in inflammatory conditions except for pneumonia and sepsis. Total T and active T cell distributions were paralleled each other in every disease conditions.